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HEALTHCARE | Healthcare Plans
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Founded Year

1937

About Blue Cross Blue Shield of Massachusetts

Blue Cross Blue Shield of Massachusetts is a commercial health plan.

Blue Cross Blue Shield of Massachusetts Headquarter Location

Boston, Massachusetts,

United States

800-262-2583

Latest Blue Cross Blue Shield of Massachusetts News

Payer Services Markets, 2015-2020, 2020-2025F, 2030F - ResearchAndMarkets.com

May 24, 2021

May 24, 2021 07:03 AM Eastern Daylight Time Major players in the payer services market are United Health Group, Anthem, Concentrix Corporation, United Healthcare, Anthem Inc., Aetna, Inc., CIGNA Corp., HealthPartners, Blue Cross Blue Shield of Massachusetts, and Group Health Cooperative. The global payer services market is expected to grow from $93.905 billion in 2020 to $101.764 billion in 2021 at a compound annual growth rate (CAGR) of 8.4%. The growth is mainly due to the companies resuming their operations and adapting to the new normal while recovering from the COVID-19 impact, which had earlier led to restrictive containment measures involving social distancing, remote working, and the closure of commercial activities that resulted in operational challenges. The market is expected to reach $183.723 billion in 2025 at a CAGR of 16%. Increased adoption of technologically advanced products is gaining substantial popularity in the payer services market. This has led to improved price transparency, affordable payer services, higher utilization of resources, increasing quality reach, and member satisfaction and loyalty towards the service provider. For instance, in July 2019, Blue Shield California (BSC), with the help of Gemini Health, has built up an online tool to remove out-of-pocket drug spending for individuals. The price transparency tool plots the cost data for accessible suppliers and medical clinics. The innovation recommends lower-cost choices like it coordinates the current drug with lower-cost, dose-equivalent options. In April 2020, Molina, a US-based company engaged in providing managed care in the field of medicare and medicaid programs, announced that it will purchase Magellan Complete Care (MCC), a managed healthcare organization, in a deal worth about $820 million. The acquisition is expected to expand Molina's geographic footprint in its core businesses of managed medicaid. Magellan Complete Care (MCC) is a US-based company offering care management solutions. The increase in healthcare frauds is expected to drive the payer services market for tightening its security systems. Healthcare fraud includes malpractices such as individuals obtaining subsidized or fully-covered prescription pills that are actually unneeded and then selling them on the black market for a profit billing by practitioners for care that they never rendered, filing duplicate claims for the same service rendered, altering the dates and modifying medical records. The healthcare industry continues to suffer losses attributed to frauds and errors. For instance, according to the National Health Care Anti-Fraud Association, in the USA the loss from healthcare fraud was estimated to be $300 billion in 2018. Therefore, increasing healthcare fraud in the healthcare industry is propelling the demand for rigid security systems, thereby driving the growth of the payer services market. The rising incidences of data breaches and loss of confidentiality have always been a major challenge in the payer service industry. In recent years, the healthcare sector has always been at the forefront in cases of breaching privacy and the resulting loss of confidential data. The healthcare sector accounted for 45% of data breaches in 2019 costing the sector more than $17.76 billion. Moreover, in August 2019, Avenna Healthcare in Georgia detected a phishing attack on 166,077 patients in February and began notification of a potential breach. This was caused due to improper maintenance of information leading to vulnerable cyber-attack. Rising incidences of data breaches and loss of confidentiality are thus hampering the growth of the payer service market. Key Topics Covered:

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CB Insights Intelligence Analysts have mentioned Blue Cross Blue Shield of Massachusetts in 1 CB Insights research brief, most recently on Sep 29, 2020.

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